Geneva 30 May 2011 Essential Medicines for Children in India Gitanjali Batmanabane MD PhD Technical Officer - Essential Medicines & Other Drugs World Health Organization Regional Office for South-East Asia New Delhi

2 |2 | Gitanjali – Geneva May 2011 Overview of BMC-India  What was the problem we were trying to resolve?  How did we get started?  What processes are we using? What have we done?  What are our most important current challenges?  Where did we get stuck?

3 |3 | Gitanjali – Geneva May 2011 What was the problem we were trying to resolve?  Highest number of children dying before their fifth birthday  3 die/minute – neonatal sepsis, diarrhoea, pneumonia  Too many medicines  Quality may be an issue  Medicines widely available  Cheap  Most parts of the country are well connected  Health systems are in place  Procurement systems are in place

4 |4 | Gitanjali – Geneva May 2011 How did we get started?  Selection of states  Chhattisgarh & Orissa chosen  Poor health statistics  EMLs of the two states were analysed  Very little children’s medicines on the list  National EML  Mistakes, very few children’s medicines, not current (2003)

5 |5 | Gitanjali – Geneva May 2011 What was planned  National level activity  Preparation of EMLc by the Indian Academy of Paediatrics  State level activities (Chhattisgarh & Orissa)  Conduct pricing and availability surveys  Prepare a state EMLc

6 |6 | Gitanjali – Geneva May 2011 What processes are we using?  Selected a professional body – expertise, many key opinion leaders, ownership, advocacy  All basic documents were given – group of members received background information at a two day consultation  First draft prepared and presented – feedback given  Revised many times over

7 |7 | Gitanjali – Geneva May 2011 What processes are we using?  Selected a team in each state – which had experience and previous training  Report of the comparison of the state EML with WHO Model EMLc was given to the team  Word document template of WHO Model EMLc given  First draft prepared and presented – feedback given

8 |8 | Gitanjali – Geneva May 2011 What has been done?  National level activity  Preparation of EMLc by the Indian Academy of Paediatrics  State level activities  Conduct pricing and availability surveys  Prepare a state EMLc Baseline pricing and availability surveys done State EMLs have been prepared Final draft stage of the IAP EMLc

9 |9 | Gitanjali – Geneva May 2011 What are the current challenges?  Getting permissions – time, delegation of responsibility, signature of govt. officials  Communication – contacting PI  Budget - under or over estimate  Report writing  Quality of data, quality of the EMLc

10 | Gitanjali – Geneva May 2011 Where did we get stuck?  Preparation of EMLs – concept & principles of selection  Professional bodies – the EML is no one’s baby  Even if EML is ready – procurement is a long way off  Ethics clearances, financial issues (bank account)  Post survey refractory period